Lecture 1:
Developing the Communication Matrix to Answer the Question: What CAN They Do?

Description:
The Communication Matrix was developed to fill a gap in assessment practices: at the time, there was no instrument to describe how individuals who can’t speak CAN communicate. The emphasis of existing assessments was strictly on spoken communication, and there was no means to document the many ways that someone without speech could communicate using other means. In 1990 the Communication Matrix was created to fill that gap. Since then, a series of grants from the U.S. Department of Education has supported progressive improvement of the web site that was designed to allow parents and professionals to administer this assessment online. The latest and current grant underwrites the development of a virtual community of practice for professionals and nonprofessionals who support individuals with complex communication needs. This session will present the story of the Communication Matrix--its foundations and its evolution into the current complex web site that is used around the world.

(video recorded lecture)

Charity Rowland

4

10:45 – 11:00

Break: Light refreshments will be provided

5

11:00 – 12:30

Lecture 2:
The Communication Matrix: Using the Results to Promote Progress

Description:
Children who present with complex communication needs (CNN) along with vision, hearing and sensory motor issues present educators and support staff with a unique challenge during an evaluation. The Communication Matrix offers a clear way to organize our observations of a child\'s early communication abilities and from which to consider communication partner strategies for growth. Karen will review case examples based on the results of different profiles illustrated on the Communication Matrix grid. Emphasis will be on emergent communication and the cohesive implementation of receptive strategies to promote the learner\'s advancement toward being a symbolic communicator. With each level on the Matrix, the following will be discussed:
• Receptive considerations of partner communication strategies,
• how and why aided symbol input makes sense,
• modification of symbols to enhance attention (vision and auditory),
• analysis of forms and functions to guide decision making,
• promoting engagement in literacy, beginning with the familiar,
• sample IEP objectives

Description: Individuals with cortical visual impairment (CVI) present with a unique collection of visual and behavioral characteristics. These characteristics provide the foundation for specialized assessment using The CVI Range which determines the degree or level of functional vision. The scores derived from The CVI Range are then used to guide interventions and accommodations that are applied to meaningful routines of the day. This presentation will provide an overview of these principles. Photo and video examples will be used to illustrate key concepts.

(video recorded lecture)

Christine Roman-Lantzy

4

10:45 – 11:00

Break: Light refreshments will be provided

5

11:00 – 12:30

Lecture 2:

Integrating CVI Interventions, Strategies and Accommodations into the Instructional Program at The Bridge School
Description:
Cortical Visual Impairment (CVI) is a unique type of visual impairment which often co-occurs with cerebral palsy and other neurological disorders associated with severe speech and physical impairments (SSPI) and complex communication needs (CCN). Little is understood about how to best support the specific visual needs of students with SSPI and CVI who rely on AAC for daily communication needs and participation in academics and literacy instruction. To maximize the participation of these students, The Bridge School has developed interventions, strategies and accommodations based on The CVI Range, an assessment tool which provides rich descriptive information about a student\'s visual abilities and characteristics.

This presentation provides practitioners and educators with strategies to support systematic implementation of accommodations developed to recruit and increase use of a student\'s vision for communication, academic instruction, assessment, and accessing the environment. These interventions are embedded within classroom activities and based upon student considerations, teaching considerations, environmental considerations, and individual AAC and AT tools and strategies. These accommodations lead to changing expectations for students using their vision during instruction, all ultimately support vocabulary and language acquisition, increase effective use of all AAC modalities, and support the development of literacy skills. We will discuss preliminary outcomes and progress in these areas for our students with CVI.

Description:
One body of clinical practice often implemented with individuals with intellectual and developmental disabilities involves aided augmentative and alternative communication (aided AAC). Most of these systems involve visual displays containing written words, icons, or other visual-graphic symbols. The intent of these systems is to offer a supplemental means of communication to individuals with disabilities whose speech is not adequate to meet their receptive and/or expressive communication needs.
Aided AAC relies on a visual modality. Consequently, it critical that individuals who use AAC be able to perceive or process the visually-presented information; otherwise, the system will not be used effectively. Yet AAC display design and the ways that individuals process this visual information has received little research attention, nor is there much information about visual processing in individuals with significant intellectual disabilities. This gap means that many displays that are intended to promote communication may be confusing or sub-optimal for the individuals who they are intended to benefit.
This presentation will illustrate how eyetracking analysis can reveal patterns of visual attention to AAC displays in individuals with significant communication and intellectual disabilities, who are difficult to test using traditional experimental tasks and methods. I will describe what elements of AAC displays attract attention, and which distract from efficient search in individuals with Down syndrome, intellectual disability of unknown origin, autism spectrum disorder (ASD), and nondisabled peers. (Supported by NICHD P01 HD25995, R01 HD 083381, & the PSU Hintz Communicative Competence Endowment)

Description:
Despite widespread use of the Picture Exchange Communication System (PECS), many minimally verbal students with autism fail to initiate even basic requests in the absence of adult directives. In many cases, this lack of spontaneity is the result of instructional errors during PECS implementation. The first part of this session will identify the most common of these errors and offer suggestions for remediation.

The second part of the session will discuss the need to move “beyond PECS” in order to provide opportunities for students who rely on AAC to initiate messages through the use of core and fringe vocabulary displays.

(video recorded lecture)

Pat Mirenda

6

12:30 – 1:30

Lunch

7

1:30 – 3:00

Lecture 3:
Mobility Matters: Students with Speech and Physical Impairment use Hands Free Support Walkers to Explore, Discover, Learn and Participate in School Activities

Description:
This presentation describes an element of the Bridge School program from 2006 to 2015 in which 29 students (22 boys and 7 girls: 3-10 years) participated in self-initiated mobility experiences through the use of hands-free support walkers and thematic activities embedded into the curriculum in ways that contribute to the foundation of learning and development. Students who participated in this program demonstrated a positive increase in peer interaction, engagement, self-initiation, problem solving, physical motor control, and use of the upper extremities. A theoretical framework based on current research and longitudinal observations of students participating in the self-initiated mobility experience will be discussed. A variety of techniques, activities and devices for imbedding self-initiated mobility into curricular activities and environments and a range of considerations used to select a child\'s support walker to maximize fit, function and access will be shared through slides and videos.

(video recorded lecture)

Christine Wright-Ott & Fei Luo

8

3:00 – 3:15

Break

9

3:15 – 4:15

Lecture 4:
The Importance of Seating and Access in AAC Success.

Description:
Principal Occupational Therapist, Chuan Hoh, will be sharing his experience working with Speech Therapists to serve individuals with complex communication needs and his role in the team.

Tan Chuan Hoh

10

4:15 – 4:30

Questions, wrap up

Sarah Yong

Speaker Bios

Sarah Yong

Sarah is a Speech Language Therapist by training and is Manager of Clinical Services at the Specialised Assistive Technology Centre, SPD, Singapore. Augmentative and Alternative Communication (AAC) is a key area of focus in the Specialised ATC. She manages a multidisciplinary team of OTs, STs and Engineers who work together to assess and provide intervention for individuals with disabilities who need AAC and AT. She was the Bridge School Teacher In Residence (2002-2003).

Sarah’s specific interest is in Augmentative and Alternative Communication and how it can empower individuals to communication. At the ATC, Sarah provides assessment, training, public awareness and capability building in the area of AT/AAC. She has the privilege of working with many individuals with Complex Communication Needs, and their familities. She has also led several projects to integrate AT into Special Education and Early Intervention Classrooms. She lectures on AAC at the NUS for the Master’s of Speech Language Pathology Course and is also actively involved in the AAC scene internationally and is VP in ISAAC where she looks at the interest of countries where AAC is still emerging, Her passion is to enable individuals to overcome barrier, maximise potential and find their voice through the use of AT.

Tan Chuan Hoh

Chuan Hoh is an Assistive Technology (AT) Specialist at the Specialised Assistive Technology Centre (ATC), Society for the Physically Disabled. He is a certified Assistive Technology Professional (ATP), awarded by the Rehabilitation Engineering and Assistive Technology Society of North America (RESNA) since 2005. He also holds a Certificate of Advanced Professional Development (with Distinctions) in Assistive Technology Applications from the California State University, Northridge, USA. He is an Occupational Therapist by training and has a Master of Science (Occupational Therapy) from the University at Buffalo, New York. He specialises in AT applications with neurological and musculoskeletal dysfunctions especially in the areas of computer access, powered mobility and environmental control. He works closely with the Speech and Language Therapists in prescribing assistive technology solutions especially in the area of seating and powered mobility equipment to persons with physical and speech impairments.

Mariam Mohd

Sim Mariam Mohd is an NIE-trained Teacher who currently serves as an AT Specialist at the Specialised Assistive Technology Centre (ATC), SPD, Singapore. She is a part of ATC’s multidisciplinary team, providing AT support and Literacy & Learning Intervention for clients with complex communication needs. Mariam’s key focus is developing educator/caregiver training and supports—both for mainstream and SpEd schools—to adopt practical approaches in implementing technologies in school and at home to enhance learning, and to advise on classroom assessment adaptations. She provides training and public awareness workshops on Assistive and Learning Technologies and is actively seeking collaborative opportunities to help students with SEN achieve success.

Yong Seng Koon

Seng Koon is a young man with athetoid cerebral palsy. He uses the Touch Chat HD with Word Power app on the iPad Pro 12.9 which allows him to communicate using symbols and text. He has conducted a few tours in TechAble, Enabling Village, introducing Assistive Technology to children and polytechnic students. In his free time, he enjoys playing Boccia and writing to his pen-pals.

Deborah Yong

Deborah is a Speech-Language Therapist/AT Specialist at the Specialised Assistive Technology Centre, SPD, Singapore. She has practised in Kuala Lumpur and Singapore, providing intervention for individuals with speech, language and communication disorders. She currently works with individuals with complex communication needs and their parents, teachers, and/or support personnel on integrating Alternative and Augmentative Communication (AAC) systems into the home and school environment to empower them to communicate effectively. She enjoys coaching parents in strategies to facilitate AAC usage at home, conducting group therapy sessions and planning AAC parties! She believes that everyone deserves and wants to be heard.

Aileen Arai

An Education Specialist at The Bridge School, with 22 years of experience in the Bridge classrooms, Aileen specializes in designing and implementing instructional strategies that support her students’ participation in academic and social curricular areas. Aileen works with the team at Bridge School to support children gaining the skills and knowledge they need to transition back into their home school placements so that they are able to participate meaningfully in their home school environments. Her areas of interest are development of literacy within the Common Core State Standards for students who use AAC systems and addressing intervention strategies and assessments as they relate to Cortical Visual Impairment protocols and tools developed by Dr. Christine Roman-Lantzy.

Sarah W. Blackstone, Ph.D., CCC-SLP

Dr. Blackstone, a Speech-Language Pathologist who specializes in AAC and has been around for a long time, recognizes that children with CVI AND CCN continue to present unique challenges to the field of AAC because it relies so heavily on visual modes of communication. This project has been an effort to encourage a more systematic, nuanced approach to understanding and supporting children with CCN and CVI and to help discard prevailing myths in the treatment of this group. She says that “the opportunity to work with Christine Roman-Lantzy and staff at The Bridge School and CATIC in Mexico City on this important project continues to be fun, enlightening and an honor.”

Caitlin Sale, M.A.

Caitlin Sale is a special education teacher with the Mount Diablo Unified School District. Currently she teaches a middle school classroom under the TRAIL program (Technology Resources for Accessible Independent Learning), working with students who use augmentative and alternative communication while participating both in a special day classroom and in inclusion classes. From 2010-2016 she worked as the preschool teacher at The Bridge School. During her time there she worked with the team to learn more about cortical visual impairment and how to support students with CVI, complex communication needs, and physical impairment. Caitlin has presented on a variety of topics related to being an educator working with students with complex communication needs and physical impairments at the local, national, and international level.

Fei Luo

Fei Luo, Ph.D., CCC-SLP is a research associate and speech-language pathologist at The Bridge School. She has extensive experiences working with children who have moderate to severe disabilities and use Augmentative and Alternative Communication systems (AAC). She also conducts research on analyzing different discourse genres and face-to-face interactions to assess language and communication skills as well as to evaluate the use of AAC devices or programs in interactions. Her past projects include examination of narrative production of children with ADHD and analysis of face-to-face interaction between adult AAC users with Amyotrophic Lateral Sclerosis (ALS) and their familiar partners. Her research was published in Clinical Linguistics and Phonetics and presented at various national conferences.

Pat Mirenda

Pat Mirenda is a Professor in the Department of Educational & Counseling Psychology and Special Education, and Director of the Centre for Interdisciplinary Research and Collaboration in Autism (CIRCA) at the University of British Columbia. She is a Board Certified Behavior Analyst and a Fellow of both the American Speech Language Hearing Association (ASHA) and the International Society for Augmentative and Alternative Communication (ISAAC). She is co-author of the 4th edition of “Augmentative and alternative communication (AAC): Supporting children and adults and complex communication needs” (2013) and co-editor of “Autism spectrum disorders and AAC” (2009). She has published numerous research articles and chapters and presents frequently at international, national, and regional conferences. Her current research examines the developmental trajectories of children with autism and their families, and the services and supports provided to bilingual children with developmental disabilities.

Karen Natoci

Karen Natoci earned both her undergraduate and graduate degrees from the University of Michigan in the area of Psychology, Speech/Hearing Science, and Speech and Language Pathology in 1982. Karen has always been drawn to those with complex communication needs. For years, she held a private practice working with the most physically and communicatively challenged survivors of acquired traumatic brain injury. Karen spent 15 years at Wing Lake Developmental Center in the Bloomfield Hills School district and was a part time lecturer at Wayne State University, College of Special Education, for 9 years. Karen has been using The Communication Matrix since 2002 and received direct training from Charity Rowland and Philip Schweigert through the Design-to-Learn Outreach Program while at Wing Lake Developmental Center. She spent part of this year at Oregon Health and Science University wrapping up her consulting role in the launching of the Communication Matrix, Community of Practice before moving to California to begin her new position as the Education Program Director at The Bridge School. . Karen follows an “integrationist” approach in the area of early AAC, pulling from multiple sources of information, research, and most importantly, evidence based practice and level of engagement of the AAC Learner. At the end of the day, Karen enjoys practicing piano and exploring the new surroundings of San Francisco and the surrounding Bay area.

Christine Roman-Lantzy, Ph.D.

Christine Roman-Lantzy received her degrees in Elementary Education and Special Education from Michigan State University. She worked as a teacher of the visually impaired in Western Pennsylvania for 17 years. She earned her Master’s degree in Infant Development/ Medically Fragile Infants and training in Orientation and Mobility from The University of Pittsburgh where she also taught in the Vision Studies Program for 12 years. Christine also received her Ph.D. from the University of Pittsburgh. She was the Director of the Graduate Program in Visual Impairment at Marshall University in West Virginia. She was the first Project Leader for CVI at The American Printing House for the Blind.

Christine is the Director of The Pediatric View Program at The Western Pennsylvania Hospital in Pittsburgh Pennsylvania where she has conducted evaluations of over 1000 children who have CVI. Christine has provided workshops and consultations across the United States and internationally. In addition to her work in visual impairment, Christine has been a neonatal and high-risk infant development specialist since 1990.

Her book, Cortical Visual Impairment: An Approach to Assessment and Intervention was released by The American Foundation for the Blind in 2007 and received the C. Warren Bledsoe Award in 2008.

Charity Rowland

I direct the Design to Learn research program at Oregon Health & Science University in Portland, OR. Our research is conducted in community-based settings, including public schools and homes. My interests involve the assessment, development and education of individuals who experience severe and/or multiple disabilities, including complex communication needs (CCN). My work is supported entirely by federal grants. Areas of specific interest include communicative development and cognitive development in children and adults without speech. My current grants focus on the assessment of communication skills and the creation of a virtual community of practice for professionals and parents who support the needs of individuals with CCN.

Krista Wilkinson

Dr. Wilkinson is Professor of Communication Sciences & Disorders at the Pennsylvania State University, and Editor of the American Journal of Speech-Language Pathology. She has spent the last 20 years building interdisciplinary and clinically-relevant bridges in the area of significant intellectual disability. Most recently she has brought together the disciplines of visual cognitive neuroscience, behavioral psychology, and communication intervention/developmental psychology for the unified goal of understanding visual attention and processing as they relate to the design of visual communication supports (augmentative and alternative communication; AAC). She has used a variety of techniques, including tools of neuroscience, to examine visual attention and processing related to clinically relevant questions of communication intervention in individuals with significant intellectual disabilities who are traditionally difficult to study. In this recent work, she has applied eye tracking technology to reveal otherwise inaccessible information about visual attention to visual communication supports that in turn will inform design of AAC systems.

Christine Wright-Ott, MPA, OTR/L

Christine is an occupational therapist in private practice and a consultant at the Bridge School. She has specialized in research and development of assistive technology for children with disabilities and was the principal investigator and designer of the KidWalk, Gobot and MiniBot Projects, while working at the former Rehabilitation Engineering Center at Stanford. She is a frequent lecturer at national conferences and local universities. She recently authored the chapter “Mobility” in the 7th Edition of the book, Occupational Therapy for Children.